step by step the longest march can be won

Everyone is talking about the healthcare bill in my circles. The argument about whether to support passage of some version of the senate bill reveals a pretty sharp divide among those who identify as ‘progressive' or ‘left'.

Those who claim to want the bill defeated are morally repelled by it. After all, the bill delivers millions of new customers to the rapacious private insurance companies, whose stock prices have soared since the public option was erased. After a moment of bright hope that Medicare would be expanded as part of the reform, the outcome is bitterly disappointing.

Those of us who want the bill passed can concede all the above. The progressive argument for passage is strategic and practical. First of all, there is still some room, in conference, for some of the better features of the House version to be incorporated. Those voicing defeat tend not to be talking about how to use that room. For example, theHouse bill would enable Medicaid to embrace several million more lower income people (who would be government and not privately insured). It finances government subsidy by tqxing the rich rather than taxing high end insurance policies. And it includes a small scale public insurance option that may be competitive with private plans. So one immediate strategically relevant effort would be to push congresspersons to insist on some of these things.

I think the internal progressive conflict revolves around a split in the very consciousness of people on the left. For many, to be a leftist is to stand for certain principles, to express a political identity--often coupled to an expectation that practical change in the world isn't likely. Back in the day, there were at times radical or revolutionary political alternatives to incremental reform, and an anti-compromise leftism had immediate relevance. These days, when no such radical political alternative exists, there's a danger that a moralistic radicalism turns into defeatism.

After more than 50 years of activist leftism, my experience and my sense of the current situation, leads me to urge that strategy is needed as well as values. Can we actually win reforms that will: a) improve the life chances of working people in the here and now and b) set the stage for further democratic, egalitarian change? To ask questions like that is to compel you to think about strategy: HOW do we get from here to there? What are opportunities for what kinds of change? What progressive principles can be implemented in the face of what kinds of compromise?

I've wanted universal healthcare since, when I was 10 years old, I took the ‘pro' side in a classroom debate on socialized medicine. I was initially dismayed when a progressive coalition formed in support of a co tinued reliance on employer provided insurance, accepting a government insurance program as an optionalalte44rnative to the insurance corporations. My first reaction was that this was an unholy compromise. I still feel that way. But I came to accept the logic that passing a bill that promises universal health care and that would create benefits for many now denied them might be the most likely strategy for change. And the logic goes further: the insurance industry would have to accept strong regulation in return for the vast new market it was being guaranteed.

The bill now in process embodies this logic. And I'm surprised to learn that the Senate bill would place a strong limit on insurance company profits, requiring that 85% of revenues be spent on delivering health care, limiting premium pricing in certain ways.

But, no question, both the senate and house bills are weak and problematic even in their own terms. Financing subsidy by taxing ‘Cadillac' policies is a dubious way to assure workers that this is a reform for them (even though healthcare wonks think this approach will contain costs). The house bill's best feature is that it taxes the wealthiest to pay for the cost--just what Obama promised in the campaign. The planned subsidies may well fall short of protecting people effectively. The planned regulations may have loopholes that will lead to denials of coverage or exorbitant premiums. The start dates for benefits may shock a lotof people who were hoping for immediate relief. This bill could backfire if it's promises prove to be shams. And we can be certain that the medical industrial complex will be investing heavily in exploiting its weaknesses (although insurance company stock prices have gone up this week, there's indications that company insiders are realizing that the final bill may turn them into public utilities rather than profit machines).

So there are very real grounds for progressive moralists not only to be angry at the bill but wanting to kill it. But most progressives who are thinking strategically, who are focused on mobilizing real and effective movement, are accepting this bill. Joe Bader, who's been a doctors union organizer for decades (and whose spouse Cheryl has also spent her life in healthcare organizing) sent this the other day:

"the cold, hard, truth [is] that if this bill is defeated, it will be another decade or two until we get around to healthcare reform again...and THAT is morally unacceptable, given what we know are the consequences of our broken, and often cruel healthcare system.

One good thing about this dirty, "sausage-making" process called legislation is that many have been awakened to the manner in which our ruling, corporate elites and their servants in government exercise power (we already knew that intellectually, but being slapped in the face with it gives one new awareness). We will be continually reminded of this in the political battles to come, namely: climate change-carbon reduction, financial regulation, immigration reform, EFCA (remember that?), and the growing U.S military-economic involvement in overseas military adventures, among other battles.

So, after this "awakening" will our response be a new passivity in the face of adversity or a renewed activism? If we become cynical about the possibilities of reform and that leads to passivity and pursuit of a privatized existence, that leaves the field wide open for Wall Street, Insurance company executives, Big Pharma, corporate media, and the military-industrial complex to exert continued domination over our lives.

President Obama told us repeatedly during his campaign that the campaign was "not about him" but about "us" and that "we are the people we've been waiting for"..

Was he wrong?"

Joe's question is the right one. Here's the song I keep singing: we need a progressive movement that's strategically focused on the goals Joe lists. Instead of hand wringing about sellouts and betrayals and disillusionments, on the one hand, or slavishly following the DNC party line on the other, we need to argue for and organize for a progressive agenda (which in large part can be defined as a series of campaigns to fulfill the promises made in dthe2008 election).

Progressives nowadays glorify FDR as the great reforming president. But go back and read how he diluted, weakened and corrupted the great social security reform in 1935. To get it passed, the bill he pushed excluded two thirds of the black population from any coverage (it deliberately excluded domestic and farm workers), provided relatively small benefits, excluded health care, and took years before people started to get their checks. Yet it's passage provided the foundation for progressive organizing and program from then on, since it established the principle that all people were entitled to a social wage regardless of their fate in the job market.

The health care bill can have a similar significance. I think the progressive leaderships bear some responsibility for its weakness. Instead of compromising at the start by pushing for the public option, it may have been more effective for the progressive coalition to have argued and organized hard for single payer instead of marginalizing it. On the other hand, those who've been active in for single payer haven't formulated a strategy for advancing it. Instead of feeling defeated by the passage of the current bill, we ought to start immediately to develop such a strategy--one that will become urgent if and when the gap between the promise and the reality of healthcare reform becomes evident

6 Comments

Comment by Jason F. on Wed 23rd Dec, 2009

Amen.

Comment by Ed Cray on Wed 23rd Dec, 2009

Dick:
I am old enough to recall the many bills that built upon the original Social Security Act,and the later Medicare Act of 1964.
House or Senate -- and yes, I'd like to see more of Waxman's subtle hand shaping the legislation -- the important thing is for us to get a bill. We can build upon it in subsequent years, relying on widespread public acceptance (as in the Medicare bill's case).
Ed Cray
P.S. While working for the ACLU of Southern California in the mid-1960's I drafted what became the first assertion that comprehensive medical treatment was a civil liberty. A few years later, I wrote a book, _In Failing Health_, documenting issues we are still trying to resolve. I think my credentials permit me to comment on the subject.

Comment by Charlie Barone on Thu 24th Dec, 2009

Dick - I have been waiting to see something like this from a progressive all month.
As someone who's spent a lot of time inside the beltway, I can tell you that Obama had his work cut out for him in getting D's in both the House and Senate on board anything. We could nitpick about where he might have pushed harder, but overall I think he did his best given where D's from the right end of the spectrum stubbornly are (and may need to be given their precarious seats- some may still lose theirs over this) and without whom this never would have gotten to 60 votes. I think Ted Kennedy would have wound up in a similar place were he still Chair of the Health Committee.
Thanks for the pragmatic insights and for, as always, keeping your eye on the long-term goals.
--- Charlie Barone

Comment by infomaniac on Thu 24th Dec, 2009

Once again the good Professor Flacks is on the mark. Let's hope we can unite to get this first step approved...and then move forward from there.

Comment by marcelino on Tue 29th Dec, 2009

Why I DON'T Want The Health Care Bill to Pass...
because it will maintain as status quo the flawed character of health care in this country and it will effectively make permanent the serious problems with our system that voters elected Obama to fix.
Dick you quote Joe Bader "...If we become cynical about the possibilities of reform and that leads to passivity and pursuit of a privatized existence, that leaves the field wide open for Wall Street, Insurance company executives, Big Pharma, corporate media, and the military-industrial complex to exert continued domination over our lives."
In response, I don't see how this predicted outcome is very different from what we can expect as result of Obama's "reform."
By writing the insurance companies into law this will make them (& Big Pharma)stronger and more powerful than ever leaving us more vulnerable to them than before this so-called "reform." This bill guarantees that the insurance industry dominates over our lives and the likely result IS continued privatization of our lives!
In effect this bill is a bail-out for the Insurance & Big Pharma industry at the expense of tax-payers.
Just as Obama's finacial bail-out of the banks rewarded the culprits responsible this bill is a bail-out (Dennis Kucinich calls it a "massive tranfer of wealth") for Insurance/Big Pharma - who are responsible for the problem with our health care system today! Just as the financial sector took our money to make themselves stronger (while not sharing the wealth with borrowers) we can expect the same with this bail-out. It is the tax-payers who will be forced to pay and suffer under this sham "reform."
As with the banks, we can expect to see Health Insurance/Big Pharma CEO's paying themselves ridiculously high compensation packages while average Americans continue to suffer under penalties or cripplingly expensive premiums, co-pays, deductibles, and skimpy health CARE.
Lastly, i don't support the passage of these bills because they are focused on providing health INSURANCE rather than real quality health CARE.
Forcing us to buy into a system that we don't care for or believe in is a violation of our freedoms. We should have the right to choose how we care for our bodies and, sadly, health insurance often only covers conventional treatments and not "alternative, holistic therapies."
The aggressive invasive approach of conventional medicine is more apt to kill you to eradicate the symptoms whereas holistic therapies support the body to treat the root causes of the problem and not just the symptoms.
Unfortunately, Obama's bill seeks to treat the symptoms, even if it kills us, rather than address the root causes.
Alas, this IS the best we can expect from Democrats (& Republicans) because, although they have different tactics, both parties do the bidding of the Health Insurance companies & Big Pharma.
In order for real transformative change to happen in this country we must believe something better is possible - because it absolutely is.
We have the money and resources to provide a health care system that covers EVERYONE in this country but as long as we keep supporting Dems who take "off the table" any bill that cuts into the profits of their corporate sponsors we're not likely to see change you can believe in - regardless of what inspiring rhetoric they speak.
A real progressive movement would understand this and would keep agitating, educating, and organizing for what is not only really possible for us but already exists in other industrialized countries. Alas, this bill will lock us into a bad deal we won't be able to get out of again. We're better off without it.

While I find these bills hard to swallow, I support them for many of the reasons mentioned by all of the above. I understand (mostly) why marcelino is upset, but truth be told I don't see how the Healthcare Industry could get any stronger than they already are. They hold American families hostage as it is, and if just an inkling of regulation can be forced upon them, then we are better for it. Their power is fully apparent to any who have to 'negotiate' with them for group health plans. There is no negotiating, but rather the acceptance of an actuarial mugging that goes unchecked in the current system.
I am a Union electrician in San Francisco, and the healthcare plan that my family and I have would fall under the 'Cadillac' Excise Tax. (I believe one of the most ridiculous phrases I've heard about this is, â€œThose who enjoy such lavish healthcare plans...â€, as if we enjoy exorbitant premiums.) Our premiums are high because of the work we do day in and day out. We perform dangerous work in environments that are far from clean, comfy, or safe. By the time our fellow members reach their mid fifties, many would be uninsurable.
But it is not just the work that jacks our premiums higher, but also our principles. We believe that we should cover the families of our fellow members. We also feel that the hourly premium should be the same for all of us: young and old, married or not, straight or gay, with children or not. We are brothers and sisters. The higher premiums you pay as a young and single member come back to you as you raise your family and as you get older.
Perhaps we could get someone to refer to organized labor healthcare plans not as 'Cadillac Plans' but as 'Lifeboat' plans instead, because we take all in â€“ preexisting conditions or not â€“ and do our best to get all of our loved ones to the finish line. If we get taxed the same as CEOs, this bill will go farther to hurt the Democratic Party than any negative ad from the other side ever could. Working families are suffering right now, and to balance this bill on their backs will be an insult to injury.
Unfortunately we didn't get prescription drug reform, or a single payer, or even the medicare buy-in for those 55+ years old. We did succeed in getting both sides of the aisle to admit that the system was broken, and although the right will exploit this whole circus to their gain in the next election, we can hold our collective heads high and say we did something.
John Doherty

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About

Dick Flacks here...sociology professor emeritus at UCSB. Budget cuts mean that I can't continue my annual course on political sociology. Maybe a blog will be a space for me to continue to ruminate and pontificate. And maybe (as a veteran teacher on these matters) I can offer some ways of thinking about what's happening nationally and locally that will be useful, as we struggle to make sense of the tortured complexities of these times.
I've been a leftwing activist for more than 50 years. What we've been struggling for all these years is full democracy--to increase the opportunities for people to have real voice in the decisions that affect them. Step by step over these years we've made some gain...but it is a long march, and one that never ends. The big barrier to democracy in our society is the concentrated power of corporations. At the same time, democracy is undermined by the felt powerlessness of people in their daily lives--the persistent belief that our problems are only our own personal concern. It's a strong cultural theme--such individualism--constantlly reinforced by mass media and everyday circumstance. But the current big crisis of the economy maybe makes it more possible for more people to understand that we've got to have social reform and economic reform. So my writing here is aimed at helping us figure out what to think and act on that so that we can hope for new democratic possibilities. WE'll be talking about the local and the national.
The blog name comes from an old labor union hymn:
Step by step the longest march can be won. Many stones can form an arch...singly none. And by union what we will can be accomplished still. Drops of water turn a mill, singly none, singly none.
For 27 years I've had a weekly radio show on KCSB (91.9 fm. www.kcsb.org) It's called the Culture of Protest. It's comes from my fascination with music and social movements. I collect 'political' and 'protest' music and that's what we play each week (Thursdays 6-7 pm). So sometimes here we'll share and talk about that.
I'm worried about one thing about the blogosphere. And that's the way that some people use the blog comment space for anonymous nastiness. I'm sick of the kind of political blather that assaults the motives of others, and sees dark conspiracy behind every thing one doesn't like. This kind of stuff is helping to poison the political atmosphere. So I'm going to strive for a civil tone to whatever interaction may happen on this blogsite.